Monday, June 30, 2008
Happy Birthday Canada
A number of years ago, back in university and anthropology professor assigned us an essay topic: How do you define what it is to be Canadian? Today being Canada Day ( this year we celebrate our 141st anniversary of Confederation), I thought I'd tell you 100 things that make me love being a Canadian. (this might be very difficult) (okay I only made it to 71 (bit over half of 141), but still pretty good.
1) Neil Young is Canadian...and he rocks! I love Neil Young.
2) I have lived literally from coast to coast...I've lived in Newfoundland and all the way to Vancouver Island...and everywhere in between.
3) I moved to Banff right out of high school. Banff is surrounded by the Canadian Rockies and is the iconic (albeit tourist related) "Canadian Wilderness".
4) I can tell the difference between a deer, a caribou, and elk and a moose.
5) I can tell the difference between a black bear and a grizzly and know what to do if I encounter either: Try to slowly back away from both. While doing that talk in a calm smooth voice to the bear. Do not make eye contact. Do not throw your back pack away...it will protect your back/neck/head if you need it. If all else fails play dead and protect your back, neck and head. DO NOT RUN...grizzlies have been clocked doing 50 km/hr...you will not outrun a bear.
Preferable tactic: Do not run into bears. Make lots of noise while hiking, bear bells don't work...and may actually increase your chances of being attacked because the sound makes the bears curious.
6) I know the song formerly known as "the Hockey Night in Canada song" Dun, du, dun, du dah; Dun, du, dun, du dah; dun, du, da, da dada..."etc. (you have to be Canadian to get it)
7) I know what it is like to drive across the prairies, and drive, and drive, and drive ad infinitum.
8) I know the word "Eskimo" is not politically correct...It's "Inuit"
9) I went camping almost every summer as a child. My Dad was a "Dogmaster" with the RCMP, which means he was a police dog handler, and had spent many many hours for years tracking lost people, or people who did not want to be found. He taught us to love and respect the wilderness. These times were some of my happiest.
10) I know that the Europeans called the First Nations People "Indians" because when they landed in Canada they thought they had arrived in India...Duh!
11) I can name all 10 provinces and 3 territories (I actually KNOW we have 3 territories).
12) I have been snowshoeing many, many times as a child.
13) Downhill skiing is a favourite winter pastime for many Canadians...and I'm one of them.
14) I actually understand the rules of Hockey, and the point of the game (I can't say that for any other group sport except maybe water polo)
15) I have participated in that great Canadian coming of age game: "Beer chugging"
16) I know it is pronounced Nefeunland, not NEW FOUND LAND.
17) I know what the Common Wealth is.
18) I love the Queen...even though it is a bunch of pomp and pageantry. I think it's a quaint tradition, and I want to continue participating in that pageantry.
19) Gordon Lightfoot is Canadian...who can beat the iconic "The Wreck of the Edmund Fitzgerald as a classic Canadian song. (This video has some great pictures of Canada, its people and the power of the ocean)
20) Joni Mitchell is Canadian. I love Joni Mitchell. I love her song "Big Yellow Taxi" and have been singing it (and can achieve the highs AND lows in the song) and playing it on my guitar for the past few weeks. My Mom used to sing Joni Mitchell's songs to us when we were kids.
22) I know how to survive (and get found) if lost in the woods.
23) Camping is a favourite pass time of mine
24) As is Canoeing
25) I know Canada has more Bald Eagles than the US...Should have been our national symbol
26) Our national symbol is the beaver...almost everyone snickers about that.
27) I have seen the fossils at Drumheller Alberta...a very cool place to visit.
28) Unlike my fellow Ontario countrymen who believe the world revolves around Toronto...I know everyone would rather live in Vancouver...hip, warm, artsy, laid back,tons of beaches, mountains...we have it all.
29) I have seen whirlpools in the ocean big enough to swallow a huge boat.
30) I know what "Skookum" means.
31) I love smoked salmon.
32) I BBQ all year round.
33) I love maple syrup...and use it in everything from salad dressings to marinades and of course on pancakes.
34) I can make a beautiful snow angel.
35) I have seen mosquitoes as big as my hand in Winnipeg, Manitoba (well maybe that's an exaggeration, but they are pretty damn big)
36) I have lived near the Columbia and the Fraser rivers..two of Canada's most famous rivers.
37) I know what the "Great Divide" (or Continental Divide) is. It is a line across Canada where on one side the rivers run towards the Atlantic ocean, and on the other side they run towards the Pacific ocean (no lie)
38) Even though I'm a pacifist, I am proud of our Veterans in World War I and II. My Dad said almost anywhere he went in Europe people spoke fondly of Canadians and their contribution to winning those wars.
39) "Oooh..your Canadian let me help you". Once people in Europe realized I was Canadian and not American..their whole attitude changed; suddenly I became part of the family.
40) I speak "Franglais" a sort of brutalized anglicized version of french. Bonjour Madame parlez-vous English...PLEASE???
41) Despite my difficulties learning French (It is the only course I have ever failed in my entire life...I took it again and passed though). I am glad we have two official languages, and when I've been to Quebec I try really hard to speak French...but I am really bad at it. At least I try.
42) I have built an igloo.
43) I have made and eaten Bannock.
44) I have ice skated on numerous frozen ponds, including one year on the pond on the farm (it is unheard of for it to get cold enough, long enough for that to happen here in Vancouver, but one year it did.
45) I know that what we call a creek in B.C. is actually a "brook" in Newfoundland.
46) I have seen killer whales up close in the wild. They are so beautiful it is indescribable.
47) I love the Vancouver Canucks (even though I'm not a big hockey fan).
48) I know that "football" in Canada is that game where ridiculously huge men bend over a lot and try to do something with a pointed spherical (sort of) shaped ball: A game, the rules of which, only about 100 people in all of Canada understand while the rest pretend to understand.
49) I have been to Magnetic Hill in New Brunswick...it's a road where it seems as though you are going uphill, when really you are going downhill. It has some kind of optical illusion properties so if you park in neutral at the foot of the hill your car actually rolls "uphill".
50) I love lobster
51) I've seen many icebergs off the coast of Newfoundland.
52) I have lived in 5 different Provinces.
53) My father is retired from Canada's iconic police force: the RCMP. He was a member for more than 40 years. Three other family members are , or are retired, from in the RCMP. It is a family tradition
54) I skied in the Canadian Rockies many times as a kid...Jasper, Banff, Lake Louise. Great ski hills.
55) You see nature everywhere, even in the city. I saw a coyote cross 57th and Victoria; a very busy major intersection. He looked like he knew exactly what he was doing too.
56) Blueberries in B.C. are on really tall bushes, where the pickers often need to use step stools to reach the top berries. In Ontario and the Maritimes the blueberry bushes are short and you have to bend over to pick them.
57) In one day I can swim in the ocean, sail, go play golf and drive up to the mountains to go skiing at Whistler/Blackcomb...that's how close this city is to everything.
58) If you like to swim outdoors "Kit's Pool" in Vancouver is the longest pool in Canada...137 Metres, and it is a salt water pool.
59) I actually know the words to our national anthem..." O Canada". A huge number of Canadians have no idea...they changed it in the 1970's and it confused everybody.
60) I know all sorts of names for snow: sleet, slush, powder, crunchy, wet, dry, snowstorm, blizzard...the list goes on.
61) I have been caught in a blizzard before, when I was young, 8 or 9. I thought I was going to die. I couldn't see where I was going and it was minus 40.
62) I lived on a farm in the prairies as a child and we had horses, ducks, chickens, geese (all pets of course). We had to hand carry water down to the barn and it was hell in the wintertime, but I still look back at that period of my life and think it was idyllic.
63) I've shot tin cans off the fence with a rifle when I was a kid (under my Dad's careful supervision of course)
64) Hand guns are illegal in Canada...Hallelujah
65) Speaking of which...k.d.lang is Canadian. Her version of "Hallelujah" is awe inspiring.
66) and on that note: Leonard Cohen (who wrote "Hallelujah") is Canadian too. His poetry and his music is haunting. This you tube video of "Suzanne" has subtitles (dutch maybe?)
67) Robertson Davies was Canadian. His book "The Deptford Trilogy" , made up of three books (Fifth Business, The Manticore and World of Wonders), it is a marvel of a book.
68) Margaret Atwood is another great Canadian Writer.
69) as is Rohinton Mistry (while born in Mumbai, India, he immigrated to Canada in 1975). His book: "A Fine Balance" is one of the best books I have ever read.
70) In Canada we have a public medical system. This means we all have access to the health system. While all you ever hear is the negative news about public health care, I have always had the best care and feel blessed to live in a country that cares for its citizens in this way.
71) and finally...I love that Canada has adopted a multicultural approach to its people and its new immigrants and not a melting pot approach. Existing and new Canadians are encouraged to keep there beliefs, and practice their cultural traditions as opposed to being pushed to assimilate into becoming a typical "Canadian". That is the great thing...there is no such thing as a typical Canadian. This is what makes this country so interesting and continually fascinating.
We all came from different places, different backgrounds; some like our first nations people have lived here for centuries, and some of us may have entered this country today. We are a great and fantastically interesting mix of cultures, religions, and peoples who hold one thing dear to our hearts, our freedom and our democracy...and if you ever watched the Canadian parlimentary channel...you know how much they fight to ensure democracy sticks around.
I love being a Canadian.
(oh yeah...and # 72..."Canadian Girls Kick Ass"
Sunday, June 29, 2008
"...the patient was floridly manic. I don't remember the details, what I do remember was that she was running on empty, high as a kite, going 99 revolutions per minute, you name the cliche. There was a reason why she was on an inpatient unit and not being seen by an out patient doc. She wasn't getting better and, as is often the case with people suffering from mania, she had no insight that she was ill, she was feeling good-- really good-- and oh so energetic, and even louder than that, and so what's the problem here?
...I'm trying to reason with her, and finally, she screams at me in a way that stays clear long after her name and the details of her life have oozed from my memory, "You're problem is you're not Italian! You don't understand TRUE EMOTION!!" She had a point."
The post is really important for me and probably for other people who are receiving psychiatric treatment. When I read Dinah's post I felt so understood, like I do with my pdoc, but not like I do around other health professionals, or my family, especially my husband. I do it myself too: Dissect every tiny mood change like I'm going to go crazy either too high, or too low. It's hard to get better when I'm constantly worried about "how I AM".
When I read Dinah's post it reminded me of a situation I was part of a number of years ago. I commented the following below Dinah's blog, and I should remember this anytime I worry I might become manic...
" What a great post. Two other pdocs have given me the label "bipolar", but the one I see every week says I have MDD and a hyperthymic temperament. This I believe, but I can't help but worry every time my mood skyrockets. I am so scared I am going to go manic.
Even before someone tried to label me my friends would make fun of the hyper energy I have when I am well; my million ideas, my rapid speech, how loud I get (very loud...because I get so excited with all the ideas), how excited I get, how wild I get.
I almost bought into the labels until I went to my Great Uncle's funeral and met my Grandma's side of the family...every single one of them was like that...So "On" it was absolutely amazing. It was like being in a room with twenty people just like the well me.
We weren't Italian, and certainly, statistically, we cannot all have been manic at the same time: we just are a family of people whose personalities are exuberant, jovial, high, full of ideas, like to do a million projects at once, can fly from one idea to another and understand the connections between all these ideas with ease. Maybe everyone else was just "slow?"
The experience of being surrounded by so many people just like me was breathtaking and eye opening. I recently had the pleasure of meeting three more members from that side of the family; people I had never met before.
At a family wedding this little old lady came up to me and said, you must be "B's" daughter. I just had to meet you (she's talking really loud, and is exuberant, and excited, and very, very talkative). We have to stick together us "Family name".
No one is like us, listen to the din, the room, listen to how loud everyone is, they are excited and energized. We've always been this way. You stay here I have to grab "M" and "R" They are going to fall over when they meet you. They are just like us...and with that this 85-90 year old lady ran off to look for my new found relatives.
They all showed up, along with my uncle, my cousin, and my second cousin. The din was unimaginable. Everyone talking really loud, everyone butting into everyone else's conversations. Ideas flowing like rain pours in a monsoon, and all of us are keeping up with all the conversations. Never a pause to catch our thoughts or to let someone else speak.
Then suddenly we all went silent, looked at each other and burst out laughing. We are all just like Grandma was...it is too bizarre: Loud talkers, so excited about the world and all the things in it, a bit pushy, speaking a mile a minute, and no patience for people on the outside who don't get what is going on.
Almost the entire side of my paternal Grandma's clan have hyperthymic temperaments. When "on" we are more than on, when happy, we are beyond happy. I think that is why I have such a hard time with my depression...because when I am well I feel like I am completely in control of my life, I absolutely love being alive and I think this world is the most amazing place in which to exist. To lose that to depression is beyond devastating.
Thursday, June 26, 2008
"Writing Prompt: Set aside twenty minutes or so and do a brain dump. Just write whatever is on your mind no matter how mundane or boring. Even if you have nothing to say, write that. The trick is to just keep your hand moving the pen across the page for twenty minutes. When you have finished, sit in silence for a few moments and ask yourself how you feel. Do you feel more collected? Less scattered? Consider whether or not a morning brain-dump might be a helpful thing to add to your arsenal of wellness tools."
I am really worried about Dr. X. His office called to say he was away sick this week. He is never away, for any reason. He hasn't seemed well the past couple weeks, in fact the past couple months he's seemed a bit distracted. Now I am really worried. Worried he is sick like my Mom was sick. What if he were. I couldn't bear to lose him. How would I deal with that? I know my mind is taking me down that negative road, and for all I know he could just have the flu, but it seems like he has been worried about something lately. I even brought up my attachment to him, and how much he means to me in our sessions a couple times, because I felt something was wrong.
My mood is dropping again. Part of it is that worry about Dr. X and his well being, and part of it is the letter from my insurance company. I now feel like I am being watched (once again). At the bottom of the request for detailed minitue (sp?) of my day and any work or volunteer work I do they are making me sign the form saying I understand all my statements will be investigated and that they will contact the people I volunteer for etc. They don't get it. The more they put the fear of being spied on into me, the more I believe i am being watched, and the more I am afraid to do anything that might indicate to the non-psychiatrist eye that I am well and ready to return to work.
I am one of those people who is able to put a face on when I have to, so the studio I volunteer at, and even when i was working, my workmates and bosses, never had any idea I was sick. I can hide behind a type of false boisterousness for short periods of time, but the price I pay is exhaustion and an intense need to be alone. I believe I am working really hard at getting well, but I know I am no where near well. I need more "safe" time more time to slowly build my stamina. 5-6 hours a week volunteering in a supportive environment, where I can call in sick anytime I need to, where I have complete backup, in no way resembles a fast paced and highly stressful workplace where I am in fear of losing my job all the time.
Last week I wanted to commit suicide so badly. It isn't even that I feel as bad as I did before. I just feel like I will never get WELL...the capitals are intentional and represent the well that is me when I feel empowered, completely not depressed, powerful and excited about life, social and extremely outgoing.
All I want now, even though I feel better than I did, is to hide away at home, not answer the door, keep the curtains closed (so no one can watch me).. I have the means and opportunity to commit suicide. Last week I didn't because all my nieces have birthdays in these two/three weeks. I do not in any way want my death associated with such joyous occasions. I just want to go, and i feel like the time is getting closer and closer.
I wish my family could understand that my going would be a blessing. My pain would end. I do not know if they understand how painful it is to feel depressed all the time. Even I did not "get" what depression really could become until these last 6-7 years. Before I was depressed, but nothing I went through came even close to the length and intensity of this major depressive episode.
I have to teach today. I feel stressed out and angry that i have made that commitment. All I want to do is crawl into bed and stay there. Hide form the world, hide from myself, avoid life...this in itself is a "little death". Maybe if I do this long enough I will disappear.
20 minutes is harder than I thought. I don't know if any of you get what I mean when I see death as an intense relief. I think anyone who has not been depressed has a difficult time getting it. Even my pdoc. I think he gets it on an intellectual level, but I think he believes the desire to die will end with the relief of symptoms. I don't think that is true for me, because for me...I KNOW the symptoms will return, They never go away for ever, and every time they return they are worse. What kind of existence is that. I wish we were allowed to be put to sleep. My biggest fear is surviving suicide. I am so afraid I will miscalculate my plan and end up both severely depressed and lose my brain, or be completely physically trapped in a body that won't work. I would choose euthanasia if it were available.
I still have one more minute. I guess there is an upside to my depression. I met my pdoc and he has enhanced the life I have. I also met lots of people online who have also enhanced my life. I am grateful for that. Thanks for listening.
(20 minutes are up)
I feel exhausted. This might not be a good idea for me when depressed. It was why I stopped writing in my journals...I became too negative and focused on my depression. When well I can see how it might help me get ideas out on paper. Thanks Jazz for the idea.
Monday, June 23, 2008
What kind of monster would you be? The funny. friendly kind, that hides under the bed and strikes up conversations with the kids, helps them with their homework, plays goofy games with them, helps them get through the difficulties of childhood, answers all the kids tough questions and then disappears as soon as an adult comes into the room
Do you have a crush on a celebrity of the same sex and if so who? Cate Blanchett...she is really hot mostly because of her intelligence and talent (she's also beautiful in a different sort of way).
What do you collect--if anything? Vases and bras...I live on a flower farm and I love bras; a girl can never have too many vases or too many bras. (maybe the bra thing is a fetish)
Do you have a favorite artist? (Painter. You can name more than one): Egon Schiele, Tom Thompson, Emily Carr, Van Gogh, Diego Valazquez and Dante Gabriel Rossetti.
Do you have a habit and if so what? I hate to say it, but like James I swear like a sailor sometimes (but I can be the perfect lady when I want/need to be), I say "like" far too often...it annoys me so much, but I cannot kick the habit.
Overall, do you prefer the city or being near nature and the outdoors? I like being in the country near the city (how's that for a flip flop answer?) I like the serenity and solitude in the country, but I love the accessibility to culture in the city...art galleries, plays, the symphony etc. I hate all the crowds and traffic though)
If you couldn't live in your current country then what country would be choose to live in? Denmark (I heard on the news the other day it is the happiest country in the world, they have a great social safety net, university is paid for by the country, people are encouraged to do what they love for work, and many people change jobs many times until they find the right one and the state helps people find the job they like, six weeks holidays minimum a year, and people do not struggle to make ends meet because they always have help if they need it)
Would you like to be famous? No...I get too stressed out all the time already. I could not manage the pressure, or the lifestyle.
Are you punctual or always late? Mostly I am early...I am obsessed with time and believe people who are always late think there time is more important than mine. (of course I am late once in a while, and then I get super stressed out about being late)
Where do you find the most peace? In the chair across from my pdoc in his office, in any swimming pool when it is quiet. I feel most at home in the water.
What three foreign languages would you like to learn most (you can choose one or two if you prefer)? French, Spanish, Latin
Would you travel into space if you had the chance? Absolutely!
Speaking of all these questions, what is the question that you hate the most? Why aren't you better yet?
Friday, June 20, 2008
Thursday, June 19, 2008
I feel like Eve after she has eaten the apple whenever I receive a letter or inquiry from my disability insurance company; Naked, overexposed and afraid I will be cut off from receiving support while I try to get better.
My mood has dropped immensely over the past two weeks. I cried on my way to my appointment today. I cried much of my appointment today, and most of the way home.
To top off a bad morning, when I got home, I found a letter in my mailbox from my insurance company wanting to know EXACTLY how I was, WHAT I had been doing and for how long, what I as able to do, who I see, if I am volunteering or working, at what and for how long, what I participate in, and sign the note at the bottom saying we can have access to all your doctors notes, thank you very much (my paraphrasing of the received letter).
This letter put the fear of God into me (only God is spelled "losing money to support myself before I am well enough to do so on my own").
How do I fill this form in? I am so conflicted because my mood is so unpredictable. If you had asked me 3 or 4 weeks ago I would have been positive I was getting better, last week not so sure and this week, back to square one.
I volunteer 5-6 hours a week (2.5-3) I teach beginner's drawing, the other I show up on a specified day and help people in the painting studio if they need help (often I just show up and do my own art and no one needs my helps, but I am there if they need me.
So I struggle. I think to myself, "well, if I can teach an art class, why can't I go back and teach a banking class? what's the difference? And I am really afraid that is how the insurance company thinks?
The problem is at the Art Clubhouse I put my best face forward (just like I did at work) and I am professional and outgoing, and reliable...no matter how I feel inside, because I feel that way is my responsibility. At work I never let my illness impact my work until the end when I was so sick I couldn't do anything but stare at my computer screen. Even then, because I was so reliable for so long, my boss never even noticed me crashing and burning.
What the Occupational Therapists and staff at the Art Clubhouse don't see is that spend all morning trying to get to the studio by 1:00pm and when I leave and get home at 4pm I am so exhausted I sleep until 6 and sometimes 7 or 7:30pm. I do this everyday, even if I've done nothing all day. I feel so exhausted I feel sick.
I cannot manage to clean my house. I have not been cooking anything other than pre-made dinners, or smoothies, or eating cereal except maybe once a week or even less, when I somehow find the energy to make dinner. Even when my mood was really good I could not get these things done.
I am worried that the insurance people will translate my being able to volunteer 5-6 hrs a week, and take a guitar class, and paint sometimes as a sign that I am well enough to return to work. I know I am not. I know I can only do those things at the studio because of the type of supportive and safe setting it is. I know I can only manage that volunteering because I know that when I get sick (which I always do) I have the option of backing off on any commitments.
Anyways, I feel sick about having to fill out this form. I don't even know where to begin when some days I soar, and others I want to stay in bed all day. This past two weeks I am nosediving into the latter scenario.
I wish I had not accepted the fruit from the poisonous tree. It ties me down, frightens me, limits my ability to try new things and makes me feel like I am doing something wrong by volunteering, makes me feel guilty for accepting money while I am not working. I am constantly worried I will lose my insurance before I become well enough to work again and take care of myself.
I wish I had been able to quit my job when I became ill. I wish I had not needed to rely on a bureaucratic organization, one that scares the crap out of me, to survive.
Sunday, June 15, 2008
It was not about my difficulty coming off Valium, or my dependence on Valium, or any kind of desire to come off psychiatric medications. Rather, it was about the stigma I feel and the corresponding pressure I feel about being on medications that some people feel are too addictive and dependency creating to, as a pdoc, prescribe or, as a psychiatric patient, take.
It was also about the struggle I have in therapy to be independent and autonomous, yet needing to have my pdoc say; that may not be a good idea when that needs to be clear. Dr. X's supports our having an ongoing, autonomous Dr/patient relationship. I need that. I have many, many problems with autonomy, and independence and dependence; especially where men are concerned and even more so if that man is perceived as an authority figure by me.
I stated in my last post: "So, in keeping with not wanting to be addicted, and not wanting to be a drug seeker, also, because I was afraid the Valium was masking my possible TD mouth movements, three weeks ago I decided I should try to get off Valium."
Dr. X. never once has said I was addicted, or a drug seeker, nor has he ever even hinted at it. He has explained that taking these medications is like borrowing money from the bank; there is always a price to pay.
That price being dependency if I continue taking them, which may result in my needing more medication for the anxiety as time goes on. At which point there has to be a balance between our increasing the dosage to help my anxiety remain stable, and our looking at the side effects an increase in dosage might bring (i.e. memory problems, balance problems, attention or concentration problems etc.), and withdrawal effects should I decide to stop taking Valium.
It is me who feels the guilt and stigma of taking "momma's little helper". The fact that that term even exists speaks volume to how many people look at these medications with derision.
However, what if it really is "my little helper". What if ,taking it with my mood stabilizer and my antidepressant, it actually wards off my anxious depression? What if I can function better when I take it? What if this combination makes my life better.
Am I still addicted if I need a benzodiazepine just like I need an antidepressant and a mood stabilizer? I do believe I need medication, so why do I feel no stigma about needing Tegretol and Prozac, yet so much pressure to stop taking Valium?
Dr. X never told me to stop the Valium, in fact he subtly (maybe too subtly) questioned my reasons for wanting to go off and in his quiet, and unobtrusive way suggested staying on might be better for me.
So my post was not about me or him wanting me to stop taking the Valium, rather it was about the impetus behind my wanting to stop taking Valium: My feeling like I was a bad person for taking it.
Saturday, June 14, 2008
This mixture seems to have been the first to do anything towards helping my mood disorder's symptoms. I have taken some form of benzodiazepines (Lorazepam, Clonazepam, Temazepam and finally Diazepam) both short and long term off and on ever since I began seeing Dr. X. 6.5 years ago.
The short acting ones (especially Lorazepam) are a nightmare for me, because I get what seems to be withdrawal effects each day as they wear off and become really irritable, anxious and angry. Diazepam (Valium) has been different. It has helped me immensely.
My Major Depressive Disorder( MDD) is also accompanied by constant and debilitating anxiety attacks and sometimes panic attacks, insomnia, non-stop worrying, and some OCD symptoms; checking/rechecking, contamination fears and obsessive worries and thoughts.
This time I began taking Valium to ease my mouth movement symptoms and obsessive thoughts and music in my head (I am worried it is Tardive Dyskinesia, my pdoc suggested it is bruxism, but recently began wondering about TD too). The Valium seemed to stop the obsessive thoughts, allowed me to be comfortable in my volunteer role teaching art, helped me sleep, basically calmed me down enough so I can live a more relaxed life and not have constant anxiety symptoms. It also helped slow the mouth movements down a bit; although they are still pretty bad.
I read other's comments about benzodiazepines. The Shrink Rap psychiatrists, whose opinions I am interested in, and respect, seem very opposed to using them), also, I belong to an online support group and many people psychiatrists seem opposed to providing benzodiazepines for long term usage. I get the sense that these psychiatrists see long term need for benzodiazepines as a slippery slope to addiction and drug seeking behaviour.
So, in keeping with not wanting to be addicted, and not wanting to be a drug seeker, also, because I was afraid the Valium was masking my possible TD mouth movements, three weeks ago I decided I should try to get off Valium.
I informed Dr. X that this was what I wanted to do. He supported the idea, but told me to go off it very, very slowly; 10% or less a week. He said this would help me avoid some of the withdrawal side effects.
So I began. Within a week my good mood began slipping. I became more and more stressed, more and more depressed. By the time I went into this week's pdoc appointment I was slipping back into a deep depression. I had began craving alcohol again (and drinking again to relieve my stress and anxiety; something that I had stopped almost immediately upon beginning Valium again (a common pattern for me). I began isolating, not wanting to leave the house, unable to sit and be creative without being completely stressed out about how bad I was at what I was trying to do...the list goes on.
I asked Dr. X. about long term benzodiazepine usage. I asked him why he so readily provided them to me when so many pdocs and people seem opposed to the idea of anyone using these medications for long periods of time. I told him I had wanted to stop taking Valium because I did not want to be addicted, or dependent and because I hear so much negative press about people on these medications.
He told me that many psychiatrists would say there is a population of people where the risks of dependency and addiction have to be weighed against those people's debilitating symptoms. He said for me taking a small amount of Valium seemed to relieve me so much of so many symptoms of my anxiety. It appeared to him that my continuing to take Valium was the right choice for me (He said it better and much more coherently than that).
I expressed my feelings that some of my memory and word finding problems, and perhaps some of my balance problems were associated with taking a benzodiazepine. He told me that is possible and perhaps likely. Unfortunately the alternative for me is irritability, inability to sleep, extreme anxiety and the return of depressive symptoms. I decided I would go back on the Valium dose I was on. He seemed to think that was a good idea.
I know I build up a tolerance for Valium. It seems to stop working after a period of time. At that point I need a small increase in my dosage. I also know I have really bad withdrawal effects every time I go off it, which I need to do every once in a while for a period of time to offset the tolerance. However, I also know I am far more functioning and able to enjoy life when I take Valium.
I really worry that one day something might happen to Dr. X. and I will need to get a new pdoc, and they will not understand this dynamic the way Dr. X. does. They will think I am drug seeking if I ask for Valium, or think I am an addict, when in reality I wonder if there are some of us for whom benzodiazepines are a much needed supplement to the other medications we take.
What is the difference between a medication that is needed to maintain balance in a person's life, and a medication that the person is addicted to. I do not really understand where I fit in or to which category I belong. Dr. X says I am not an addict, nor am I drug seeking when I ask for Valium. I have to trust and believe he is right.
Wednesday, June 11, 2008
Dad: Hell, you never listened to your father's advice. Why in the hell would you buy a new car? (sort of joking I think)
Me: The same vehicles, but 3 years older, are only $3000.000 less and have no warranty, it made way more sense to buy new, plus I have never owned a new car. I just wanted a new car.
Dad: What else are you up to?
Me: (really excited)..oh, I applied for and got the volunteer position to teach 3 half day printmaking workshops to teens in the summer.
Dad: What kind of teens are they.
Me: Teens coming to the Art Clubhouse. Teen with mental illnesses.
Dad: Oh, you mean not real teens?
Me: (in my head...WTF?) (Out loud)They are REAL teens, what is that supposed to mean? They just have illnesses too.
Dad: Why the hell aren't you getting a real job, one that pays? Why the hell would you volunteer when you could be working for money.
Me: Well, I'm only volunteering to teach 3 hours a week and it's in a rehabilitative and supportive environment. I am trying to get better.
Dad: Well if you can volunteer to work you can get a real job.
Me: (wishing I'd never called, and wondering WHY I always contact him with the delusion that someday he will actually be proud of how hard I try, and wondering where I could get a job that allowed me to work just 3 hours a week and where I could feed myself and pay the rent) Dad, I am still not well. I cannot work right now. I am slowly trying to get better so I can work.
Dad: What you need is a real job. You have been doing that volunteer stuff for a long time now.
Me: (thinking yes...I've been managing a few hours a week for the last 1.5 years, but just recently began to feel safe doing that or even well enough to do that....and besides that, what I do in my volunteer work now is far more "real", much more meaningful and important than anything I have done work wise in my past). I am not ready to work yet Dad. I'm trying to get well and volunteering in this supportive environment is a safe way for me to work towards that.
Dad: Hrmfft. (Translation: you are so lame)
Me: (Hanging up from a call I initiated and entered feeling excited and proud of myself; and hanging up from the call feeling dejected, rejected, diminished, ashamed)
...bye Dad. I love you.
Dad: yup, bye. (click)
After talking with Dr. X about this, and him being supportive and suggesting it hadn't disappeared I came home and tried to paint. Leaving my appointments and trying to do what I tell my pdoc I cannot do is a common occurrence with me. Something about telling him I can't do something challenges myself to try.
So I tried, and nothing worked. I tried again the next day, and the outcome was pure frustration. I tried again the next day and I became angry and annoyed that something that seemed so easy a few weeks ago was so complicated and irritating now. I tried playing my guitar twice yesterday too, but again it ended in me feeling annoyed and angry that I could not get such a simple lesson. I had my blues lesson today and for the first hour I was awkward. My fingers and brain wouldn't connect. Simple rhythms would come and then suddenly disappear. My brain feels like a sieve; a sieve that only pours out things I want to learn, or things I want to do, things I want to retain, but instead on that holds in all the garbage I want to rid myself of; a clogged up and broken sieve.
My mood is slipping, and I'm scared the depression is sinking back into me. I am obsessing about my mouth movements (this is how the thoughts go...and they are rapid and circular and seem like they will never stop):
"Oh God I have Tardive Dyskinesia, but what if I go to the neurologist and he doesn't see the movements, so many of the movements are inside my mouth, my tongue is pushing in a weird way inside my mouth, my lips are pursing, and it feels like my lips are really tight together, my teeth are tapping, and grinding and clenching, but the only external notification of this is a tiny movement by my temples which is covered by my hair, My cheeks and lips are making strange movements every once in a while, my eyebrows are going up every so often, my toes are wiggling annoyingly but maybe I am just so conscious that I have a problem that I am making it happen, I feel it, but what if I'm just making it happen by thinking about it so much, what if the neurologist thinks I'm faking it, what if he doesn't believe me, what if he doesn't see what I'm seeing and feeling, what if he says nothing is going on, but I know something is going on, and I'm scared it will get worse, but what if no one see it, or believes me, what if it really isn't there and I'm imagining it (not consciously, but subconsciously), I have had so many times when I have felt physically ill, or like something is wrong and it often turns out to be nothing, what if I'm just a hypochondriac, but what if it's real, and what if it is permanent, and what if it gets worse, Oh God, I have TD....etc., etc."
This is what was going through my head all day yesterday, and it is back again today. The thoughts are obsessive, and relentless. On top of this the 4-8 bars of repetitive music is starting to come back into my head; the same beat/section of a song, over and over and over.
I'm not sleeping well again. I am irritable. I am feeling much more anxious. I do not want to see people. I have avoided the art clubhouse. I feel depressed again.
Oh God, please do not let my depression return .
Sunday, June 08, 2008
"I guess the question I'd have to ask is: what has been the most helpful thing you have done to help manage your depression? or, how do you get through your
toughest days? I guess you can answer either of those".
I am not sure how long Deepblue has been following my blog, or what s/he knows about my situation. I have had Major Depressive Episodes (MDE) since I was 17 or 18. I always managed to pull out of them either on my own, or with a small amount of counselling, until I was 31 or 32 (I'm now 42). At that time I sought long term counselling (2 years/once a week), and then I was referred to an outpatient Cognitive Behavioural Training (CBT) group and then a group therapy program, both of which did not help me at all. I had tried CBT in therapy when my MDE's were mild to moderate, but this time my depression was become far worse than ever before. For about a year my MDE went into remission on it's own (with some residual symptoms...not sleeping, irritable, fatigue).
In the summer of 2001 I became despondent and requested more help from my family Dr. She referred me to the Mood Disorders Clinic and on October 3, 2001 I met my pdoc. He invited me to become his patient. I knew as soon as I began talking with him, that were a perfect match. I agreed and began seeing him for therapy and a search for medications. He and I have worked for 6.5 years to try to help me manage my symptoms and my depression. It has been a brutal and tough journey. No medications worked for me; and I tried almost everything you can think of (more than 35 different medications in total, either alone or in combination with other medications) Part of the problem was that not only do I have MDD, I also have anxiety and OCD problems. I think this makes my depression harder to treat.
Back to your first question: " What has been the most helpful thing you have done to help manage your depression?
Until the last month or two, I would not even say I was managing my depression. I was literally trying to "Survive my Depression". There have been a few things:
1) The first most helpful thing I did was find a pdoc that I could receive both therapy and medication advice from. A pdoc who was supportive, authentic, available, hopeful, intelligent, and who I connected with on a personal level. There were weeks and weeks where all that kept me going were thoughts that "I have an appointment in three days. I can survive until then".
In some of my worst moments I would visualize myself laying on the floor in Dr. X's office (no I have never really laid on his floor). The thought of just being near his calming presence helped me calm down.
I never have told Dr. X. this, but one day he left a message on my voicemail at work asking me to call him. I never erased that message until the day I left work. Whenever I was so stressed out I wanted to kill myself in the staff washroom, instead, I would go to my phone, pull up the phone message, listen to his voice, maybe repeat it a few time and something about his voice magically helped me survive...I know it's weird...but it helped
2. Medication that worked is the second thing.
Years of therapy and support helped me survive and try to get going and begin to "live with my depression", but as soon as I found a medication that helped, I was suddenly able to make a huge transition. Suddenly my anxiety dissipated, I lost most of (not all) my fear of people. I wanted to leave the house (vs.having to force myself out of the house), I wanted to see people, I wanted to experience new things. I felt hope. I saw the possibilities. I became more motivated. I began sleeping better. My mood lifted.
I would not say the medication was a miracle, because I had been working so hard on setting up a foundation to begin with, but suddenly, along with medications that worked, my foundation became like rich soil feeding growing plants and I was finally able to grow and blossom very quickly.
I have to say, the bloom has fallen off my plant a bit lately, but I still feel like I am strongly supported by the medications. I think in the beginning, when the medications first helped my mind was so blown that I actually could feel okay, that I ran with it above any of my expectations. Now I feel more like I have a long way to go to get well, but the medicine will help me get there.
3. Build and Create a life that has meaning and purpose. I have always been angst ridden about my life. Except for the time I was in my third and fourth years of university, and doing EXACTLY what I thought mattered, and exactly what supported my feeling that I was doing something meaningful and purposeful, I have always had a sense that I am wasting my life; that I will die and my life will have been meaningless.
I am really interested in existential psychology, because it speaks to this exact thing. So Dr. X. and I have worked really hard to help me slowly build a life full of meaning and purpose. It began slowly, but initially I thought, maybe if I give back to the world somehow I would feel better about my existence. So I began volunteering to walk dogs at the local SPCA. It was a start. I felt that no matter how depressed I was being around a dog would help me, and it was a flexible, drop in when you can situation, so days I couldn't leave the house, or even my bed, I didn't have to.
I realized I needed something more meaningful than walking dogs, so the next year I volunteered for our city's Shakespeare festival. This time I had to commit to one shift a week. That scared the hell out of me. It meant even if I was sick I had to go. It came with many therapeutic moments. I worked with people who either did not have a mental illness, or were not "out" about it. I struggled. My medication and medication changes made it difficult for me to think straight sometimes. I felt really self conscious. I was terrified. I did it anyways, and I got through the first season. The second season was less difficult, except I became so severely depressed part way through the season that I left, thinking I was going in for ECT. Even though I had to leave it helped build my confidence to try something even more challenging.
I began volunteering at the Art Clubhouse for people with severe and persistent mental illnesses. I took classes there, and eventually I began volunteering to apprentice classes with an O.T. and now I am volunteering to teach classes there. This all during the period before my medications worked.
It was hell, but I also loved it. It was hard to manage my responsibilities when I was so sick, but the structure really helped me leave the house, get out of bed, relearn to communicate with people, learn to lessen my social anxiety by exposing myself to more and more social situations: meetings, classes, and teaching. A structure to depend on, and one that was meaningful, and purposeful to me, helped me live with my severe depression.
4. Writing in this blog
For lots of reasons. First I have met some really interesting and caring people in the blog community. I feel like I able to be so open and honest here. It feels purposeful to me. I really hope that people who come here and are struggling with mental illness see what I write and realize they are not alone. I never want to provide false hope, because so many times I have written about feeling completely hopeless, but I know for me there is something about knowing I belong to a shared human experience that lessens my load. I hope that is what I help people with; providing a sense that we are not alone in this world, or in this battle.
The last question you ask is: "how do you get through your toughest days?"
I wrote a post a while ago titled: "Coping Strategies for Treatment Resistant Depression (TRD)"
Saturday, June 07, 2008
You are, by the way. (is that your question? or do you want to ask another question, or suggest a topic for me to write about?...I'm open to another question...
Deepblue I know you are my 5000th visitor because you left a post on my blog at 10:53 and my 5000th visitor viewed my blog at that time (the "sitemeter" icon on the sidebar of my blog is free and it gives me simple statistics about how people find my blog (i.e. what they used in google that made my blog show up, times of visits, #'s of visits to my site per day etc.) It is really great because I can see what interests people and think about that when I write. I think you can click on the icon and it will give you a summary of what it tracks.
It says it tracks location, but it must track the city and then maybe your internet provider's address, because I looked up myself and it is nowhere near where I live. When I first saw "sitemeter" on someone's site I was worried about what kind of information it had about me...but having downloaded it to my site and viewing my own information that it tracks I feel pretty confident that my privacy is still protected.
I want everyone to know that I respect your privacy and only use the sitemeter to make my blog more interesting.
P.S. my visits are not tracked as part of the volume of visitors. You can set it to either include you, or not. Idid not include myself as it would skew the #'s.
Friday, June 06, 2008
As my mood remains better, my expectations of myself increase. I feel I should be able to do what I did when I was well; things like work, and read, and remember things, and not have difficulty doing simple tasks. I feel I should be fully functioning, now that I have felt better for a while, but that is not the case either.
I still cannot read. I used to be one to have 5-6 books on the go at any given time. I could leave a book for months and pick up where I left off, remembering the plot, characters and themes from what I had read previously. This seemed like a simple, everyday thing to me.
Now I pick up a book, read a chapter, and sometimes, even while reading that chapter get confused, because I cannot remember who is who, or what is going on. I often read and re-read the same paragraph or pages over again because I get lost and cannot figure out where I got off track.
If I read a chapter and put the book down for a couple days and then pick it up again I cannot remember what happened in the previous chapter/chapters, so I become disheartened and feel stupid and lose the desire to keep trying the book.
It is not just reading. I watch a movie, and a week later I cannot remember the most of the plot line. I remember I liked it, or hated it, but cannot remember what it was about. I have been taking blues guitar lessons. Years ago I played the guitar and all through grade school and high school I was a percussionist. I understand (or thought I did) rhythms. The first guitar lesson I got home to practice and I could not remember the simple blues shuffle pattern. I went to the next class and we practiced all class and then came home and again I could not remember the simple pattern. The third lesson I recorded it. True to form I came home and could not remember the pattern, but this time I had a reminder to help me.
I feel so stupid, when before I felt like I was very intelligent. It is like I have lost big chunks of memory, or ability to store memories, or ability to learn new things. I always thought when my mood lifted these would all come back to me.
Dr. X. and I discussed this today. He said part of the difficulties may be made worse by the way I am placing negative labels on what is happening. The more negatively I see myself, the more I live up to my own expectations (those are my words, not his...he was much more eloquent). For example, by calling these things "simple", and then seeing myself unable to do them, I become frustrated that I cannot do "simple" things.
He said the rehabilitation process can take a while and, like someone being rehabilitated to walk again, it can be very frustrating to not just be able to walk like you did before. I guess I thought when my mood was better I would magically become my old self; the self that never really had to try very hard to succeed at anything I tried.
Wednesday, June 04, 2008
I get so tired everyday at this time that I feel sick, literally. The tiredness isn't "sleepy" tired, it's fatigued, "burnout" tired. So I will lay down and even though I'm not sleepy tired, will fall asleep for a few hours. I am trying hard to be okay with this. To accept that outside these few hours my mood is definitely better; so what if the trade of is a few hours extra of tiredness. At least I do not feel like this all day, like I do when I am depressed.
I am also having "mouth movement problems". At first my pdoc said it was bruxism, then three or four weeks ago he seemed to be really concerned about how my mouth was moving and took me off the Dexedrine as he said it was making the movement worse.
Last week he said they were not as bad as the previous week, but the night before I saw him I took extra Valium and two muscle relaxants because I had such a sore next from my teeth clenching and grinding. I got a bit mad at him, because I felt he was brushing off my concerns about Prozac and tardive dyskinesia. However, he told me he was aware Prozac has been seen to cause TD and he was concerned too.
Anyways, He suggested I see a neurologist to rule TD out. I told him I would like to see if it subsides over time first. In the mean time I want to come off Valium, because I think it is masking the movements. So I began cutting back slowly and already the movements are getting worse and I am not sleeping well. Argh!
I definately have Prozac induced bruxism; and I am increasingly certain I have TD as well. I have videotaped myself while I am involved in an activity (playing guitar, working on the computer) and the weird mouth movements are definitely there. Every once in a while my mouth makes really strange movements. This is freaking me out, I do not want to look strange to other people. What do I do if it is TD? When my current medication mix is the first thing to ever help me?